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Query: UMLS:C0684249 (lung carcinoma)
 23,830 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The potential of seven tracers for the metabolic imaging of tumors by positron emission tomography was studied using five experimental tumor models. The tracers examined were 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG), 2-deoxy-2-[18F]fluoro-D-galactose (2-[18F]FdGal) and 2-deoxy-2-[18F]fluoro-L-fucose (2-[18F]FdFuc) for investigating energy metabolism. L-[methyl-11C]Methionine ([11C]Met) and 6-[18F]fluoro-L-fucose (6-[18F]FFuc) were used for assessing protein and glycoprotein synthesis, while [3H]thymidine ([3H]Thd) and 2-deoxy-5'-[18F]fluorouridine ([18F]FdUrd) were used to investigate nucleic acid metabolism. The highest mean uptake by the five different tumors was found for [3H]Thd, followed in order by [18F]FDG, [11C]Met, 2-[18F]FdGal, [18F]FdUrd, 2-[18F]FdFuc and 6-[18F]FFuc. The tumor-to-tissue uptake ratios indicated that the nucleosides, [11C]Met and 6-[18F]FFuc were better tracers in the brain region. All the tracers except for the fucose analogs were suitable for the thoracic region, while [11C]Thd and [18F]FDG were superior in the abdominal region. In comparison with the primary tumor model of Lewis lung carcinoma (3LL), [3H]Thd uptake in the artificial metastatic 3LL model showed the maximum enhancement, followed by [18F]FDG, [11C]Met and the other tracers. The [18F]FDG uptake correlated with the [3H]Thd uptake. [18F]FdUrd, 6-[18F]FFuc and 2-[18F]FdGal could be used for distinguishing different types of tumors. The combined use of these radiotracers can possibly allow the assessment of tumor metabolism, and this indicates the viability of tumors.
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PMID:Tumor diagnosis by PET: potential of seven tracers examined in five experimental tumors including an artificial metastasis model. 138 72

18F-fluorodeoxyglucose positron emission tomography was able to identify previously unknown primary tumors in 2 of 4 patients after an unsuccessful conventional diagnostic workup such as chest radiography, ultrasound, computed tomography, MRI and various endoscopies. The 2 patients in which the primary tumors were detected proved to have a carcinoma of the lung, one of the patients received radiotherapy and chemotherapy after the detection of the primary tumor by FDG PET. The primary tumor of the lung demonstrated no focal FDG uptake after the successive treatment. On the other hand, in one patient with prostatic carcinoma and another in which the primary tumor has yet to be detected, FDG PET was unable to identify the primary tumor. This suggests a limitation of PET studies in detecting cancers. Because of increased glycolysis in cancer cells, FDG PET can be used to detect cancers with its high sensitivity, surveying the entire body non-invasively in one session. PET has the advantage of detecting primary tumors of an unknown origin when compared to conventional diagnostic studies.
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PMID:[Evaluation of 18F-FDG positron emission tomography (PET) in the detection of unknown primary tumors]. 1042 68

Although nuclear medicine imaging is still widely under-appreciated and underused by the medical and radiologic communities, FDG PET imaging and Tc 99m depreotide SPECT imaging are safe, cost-effective methods with advantages over CT and other imaging methods in the diagnosis and management of patients suspected or known to have lung cancer. Physicians involved in the care of these patients should familiarize themselves with both of these relatively new nuclear medicine imaging procedures. Both F-18 FDG PET imaging and Tc 99m depreotide SPECT imaging have a high degree of sensitivity, specificity, overall accuracy, and both PPV and NPV in the management of patients with a solitary pulmonary nodule. Nuclear imaging with either of these agents provides a noninvasive, cost-effective method to select patients for aggressive intervention without contributing to increased morbidity. There has not been a direct comparison of these two techniques in terms of their relative role and cost-effectiveness in the management of patients with a solitary pulmonary nodule. Both methods have incremental value over CT imaging in selecting patients with solitary pulmonary nodules either for invasive biopsy or for thoracotomy. To date, only FDG PET has been proved to have additional application in: 1. Improving the staging of patients by identifying or excluding mediastinal disease. Some authors are reluctant at the present time to deny patients an opportunity for curative resection based on the finding of foci of increased metabolism in the mediastinum (characterized by increased FDG activity) because there are occasional false-positive studies. They propose, however, that a negative study justifies a surgical approach (and an opportunity for cure) regardless of the findings on CT. 2. Evaluation of therapy and early detection of recurrence by using FDG PET imaging as a monitoring procedure. Tc 99m depreotide may have a role also in these other clinical indications for imaging in patients with lung carcinoma. It is too soon, however, to know if Tc 99m depreotide SPECT imaging, properly performed, can mimic the success of FDG PET in the detection or exclusion of mediastinal metastases, evaluating the response to therapy, and the early detection of recurrent disease during post-therapeutic monitoring.
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PMID:Nuclear medicine imaging of lung cancer. 1085 58

Purpose: The frequency of adrenal metastases from non-small cell lung cancer (NSCLC) varies between 4 to 25%. Adrenal metastases are frequently missed (78%) by Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). The purpose of this study was to characterize the patterns of adrenal gland involvement from lung cancer by 18-F-Fluorodeoxyglucose Positron Emission Tomography (18FDG-PET).Methods: Retrospective review of patients evaluated for known or suspected lung carcinoma. Results of 18FDG-PET, CT, MRI, and scans were compared.Results: From February 1996 to May 2000, 91 patients with known (85 patients) or suspected (6 patients) lung cancer were evaluated with 18FDG-PET scan. Twenty-two patients (mean age 63, range 38-88 years) had abnormal adrenal glands by either 18FDG-PET (16 patients), CT (12 patients) or MRI (1 patient). In 13 cases 18FDG-PET scan was ordered to clarify CT or MRI findings. Only 7 patients showed adrenal gland involvement: 5 patients (5.5%) with unilateral disease and 2 patients (2.2%) with bilateral disease. PET depicted unsuspected findings in 9 patients: 8 patients (8.8%) with unilateral disease and 1 patient (1.1%) with bilateral disease.(18)FDG-PET upstaged 9 patients from limited (N1M0) to widespread disease (M1), thus obviating surgical intervention.Conclusion: This study demonstrates the potential of 18FDG-PET scanning in revealing unsuspected adrenal metastases in patients with early stages of NSCLC as well as characterizing CT or MRI equivocal adrenal masses.
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PMID:12. Patterns of Adrenal Gland Involvement from Lung Cancer Shown by 18F-Fluorodeoxyglucose Positron Emission Tomography Compared to Computed Tomography and Magnetic Resonance Imaging. 1115 Jul 69

A 68-year-old man was referred to our hospital after being treated for early gastric cancer to investigate the causative malignancy, as his serum carcinoembryonic antigen (CEA) level was increased. Chest radiography showed no abnormal opacities. Subsequently, a whole-body FDG-PET was performed, which detected some tiny lesions in the mediastinum and the right lower lung field. A diagnosis of small-cell lung carcinoma was made after mediastinoscopic and bronchoscopic examinations. After chemoradiotherapy, the previously abnormal uptake of FDG was attenuated and the bronchoscopic appearance was improved, while the serum CEA and NSE levels returned to normal. Our findings demonstrated that whole-body scanning by FDG-PET could be useful for early detection of lung cancer, especially in cases of small-cell lung cancer.
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PMID:[A case of radiologically negative small-cell lung carcinoma successfully detected early by whole-body FDG-PET]. 1129 86

A 64-year-old man with a history of large-cell lung carcinoma and recent resection of a brain metastasis was examined because of a general decline in his ability to function. Whole-body positron emission tomography with fluorine-18 fluorodeoxyglucose (FDG PET) showed metastases along the spinal cord that were confirmed with MRI. Intramedullary spinal cord metastasis occurs rarely, and the prognosis is extremely poor. Whole-body FDG PET allows the entire spinal cord to be examined noninvasively compared with magnetic resonance imaging, computed tomography, and myelography.
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PMID:Leptomeningeal carcinomatosis and intramedullary spinal cord metastases from lung cancer: detection with FDG positron emission tomography. 1159 39

Positron emission tomography (PET) with FDG has shown to be of substantial value in differential diagnosis of pulmonary lesions and in the assessment of lymph node involvement with higher sensitivity and specificity than CT. A negative PET scan of the mediastinum suggests that mediastinoscopy is unnecessary and that these patients can proceed directly to thoracotomy. The method is also useful for the visualization of distant metastases. Since changes of treatment may result after identification of distant metastases PET is also cost-effective [Eur J Nucl Med 27(2000)1598; Australas Radiol 45(2001)9]. Furthermore, changes of tumor metabolism can be detected with PET at early stages after treatment, which can be used for therapy monitoring and for the detection of recurrent tumor tissue after completion of treatment.
Lung Cancer 2001 Dec
PMID:Positron emission tomography (PET) of non-small cell lung cancer. 1172 Jul 51

This study was performed to investigate the utility of FDG-PET for: (1) initial staging, and (2) restaging of the primary and mediastinal nodal lesions 2 weeks after the completion of preoperative chemoradiotherapy in patients with stage III non-small cell lung cancer (NSCLC). Twenty-six patients with histologically confirmed stage III NSCLC were accrued to this study from April 1993 to July 1998. They included 21 with stage IIIA (N2) NSCLC who were enrolled into an institutional phase II study, and 5 patients with a highly selected subset of stage IIIB disease characterized by the presence of microscopic metastatic disease in contralateral mediastinal lymph nodes who were also treated with preoperative chemoradiotherapy; N3 lesions (n=3) and minimal T4 lesions. Demographic characteristics included median age 62 years (a range from 47 to 73) and gender ratio of male 15 to female 11. Histologic types of tumor consisted of squamous cell carcinoma 6, adenocarcinoma 11, large cell carcinoma 5, and non-small cell carcinoma 4. All patients had FDG-PET imaging of the chest before the initiation and 2 weeks after completion of preoperative therapy. The FDG-PET images were evaluated qualitatively for uptake at the primary tumor sites and mediastinal lymph nodes. Standard uptake values (SUVs) were also calculated for the primary tumors and all PET findings were correlated with surgical histopathologic data. Preoperative chemoradiotherapy resulted in complete pathologic response in 8 of 26 primary lesions. By qualitative analysis, 96% of these tumors showed level 3 or 4 uptake before preoperative chemoradiotherapy. After chemoradiotherapy, 57% (15/26) of patients showed at least a one level decrease in uptake, and the sensitivity and specificity of FDG-PET for differentiating residual tumor from pathologic complete response were 67% (12/18) and 63% (5/8). Mean SUV was 14.87+/-7.11 at baseline and decreased to 5.72+/-3.35 after chemoradiotherapy (n=21, P<0.00001). When a value of 3.0 was used as the SUV cut-off, sensitivity and specificity were 88 and 67%, respectively. The mean values of visual intensity were 3.87+/-0.35 and 3.8+/-0.51 for patients who achieved pathologic complete response (n=8) and for those who showed residual cancer after the preoperative therapy (n=18), respectively. The mean SUVs were 16.97+/-8.52 and 14.03+/-6.61 for patients who achieved pathologic complete response (n=6) and for those who showed residual cancer (n=15) after the preoperative therapy, respectively. Therefore, the degree of FDG uptake before preoperative chemoradiotherapy did not provide predictive value for subsequent tumor response. For mediastinal initial staging, the sensitivity and specificity of FDG-PET were 75 and 90.5%. The sensitivity and specificity of FDG-PET for mediastinal restaging were 58.0 and 93.0%. These results indicate that FDG-PET is useful for monitoring the therapeutic effect of neoadjuvant chemoradiotherapy in patients with stage III NSCLC. For the primary lesions, SUV based analysis has high sensitivity but limited specificity for detecting residual tumor. In contrast, for restaging of mediastinal lymph nodes, FDG-PET is highly specific, but has limited sensitivity.
Lung Cancer 2002 Feb
PMID:FDG-PET in staging and restaging non-small cell lung cancer after neoadjuvant chemoradiotherapy: correlation with histopathology. 1180 91

[F18]-2-deoxy-2fluoro-D-glucose positron emission tomography (FDG-PET) is increasingly used in the diagnosis and staging of lung cancer. Despite its positive performance characteristics in non-small cell lung cancer (NSCLC), the role of FDG-PET in the staging of small cell lung cancer (SCLC) remains to be determined. We designed a prospective study to address this question. Eighteen patients with SCLC were enrolled prospectively to undergo total body FDG-PET in addition to conventional staging procedures (chest computed tomography (CT), abdominal CT, cranial CT or magnetic resonance imaging (MRI), and bone scan/bone marrow biopsy). The agreement between FDG-PET and conventional staging modalities in identifying the presence or absence of metastatic disease was compared using the Veterans Administration (VA) cooperative staging system for staging. Overall staging by FDG-PET agreed with conventional staging exams in 15/18 (83%) patients (kappa=0.67), which included eight extensive and seven limited cases. FDG-PET showed more extensive disease in two of the three patients for which FDG-PET and conventional staging disagreed. These data suggest that total body FDG-PET may be useful in the staging, treatment planning, and prognostication of SCLC. Whether FDG-PET will replace other more established staging modalities remains to be determined by larger prospective randomized controlled studies.
Lung Cancer 2002 Jul
PMID:Whole body FDG-PET for the evaluation and staging of small cell lung cancer: a preliminary study. 1205 60

Combined modality treatment (CMT) for patients with stage IIIA-N2 non-small cell lung cancer (NSCLC) is at present studied extensively. To select patients with truly stage IIIA-N2 disease, however, proves to be difficult with current diagnostic tests. Distant metastases may become clinically overt during induction chemotherapy (IC) or shortly after, revealing the inaccuracies of current staging algorithms. A prospective study with [18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) in IIIA-N2 NSCLC patients was performed to assess its value in the selection of this patient group. Fifty-seven patients received a whole body FDG PET scan as part of an ongoing response monitoring trial. Results were compared with conventional staging. In 32/57 (56%) PET suggested upstaging, which was confirmed in 17/57 (30%) with a median follow-up of 16 (range 2-49) months. These results show that using the conventional staging algorithm a substantial group of patients was understaged. FDG PET improves the selection of patients suitable for CMT.
Lung Cancer 2003 Feb
PMID:The value of [18F]fluoro-2-deoxy-D-glucose positron emission tomography in the selection of patients with stage IIIA-N2 non-small cell lung cancer for combined modality treatment. 1258 67


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